Provider Demographics
NPI:1538652987
Name:KEARNEY, JESSICA (APRN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WELLINGTON MILL RD
Mailing Address - Street 2:
Mailing Address - City:WHITESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30185-2606
Mailing Address - Country:US
Mailing Address - Phone:770-836-0504
Mailing Address - Fax:770-834-8261
Practice Address - Street 1:41 WELLINGTON MILL RD
Practice Address - Street 2:
Practice Address - City:WHITESBURG
Practice Address - State:GA
Practice Address - Zip Code:30185-2606
Practice Address - Country:US
Practice Address - Phone:770-836-0504
Practice Address - Fax:770-834-8261
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN170214363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health